多发性硬化症的多维障碍:身体残疾,认知功能障碍,睡眠障碍,疲劳,抑郁症及其对生活质量的影响-可能的常见病理途径
Simona Petrescu1,2, Maria-Melania Dumitru-Martoiu1,3, Cristina Aura Panea1,2
1Department of Neurology, Elias Emergency and University Hospital, 011461 Bucharest, Romania.
Neurology international
|November 26, 2025
概括
多发性硬化症 (MS) 患者的生活质量受到身体和认知障碍,疲劳,抑郁和睡眠不足的影响. 渐进性多发性硬化主要受到身体残疾的影响,而复发性多发性硬化则显示出更多的认知影响.
科学领域:
- 神经学 神经学
- 神经免疫学 神经免疫学
- 生活质量研究 研究 生命质量研究
背景情况:
- 多发性硬化症 (MS) 是一种慢性中枢神经系统炎症性疾病,通过身体和认知障碍,疲劳,抑郁和睡眠障碍影响生活质量 (QoL).
- 认知障碍,疲劳和睡眠质量对MS QoL的具体贡献尚未完全理解.
研究的目的:
- 调查QOL,身体和认知障碍,睡眠质量,疲劳和MS (PwMS) 患者的抑郁症之间的关联.
- 检查复发性复发性多发性硬化症 (RRMS) 和渐进性多发性硬化症 (PMS) 现型之间的这些关系的差异.
主要方法:
- 一个单一的横截面研究,涉及112个PwMS,通过物理 (EDSS,MSFC) 和认知 (SDMT,PASAT,MoCA,MMSE) 测试以及QOL测量 (MSIS-29,EQ-5D,EQ-VAS,MSNQ) 进行评估.
- 29名PwMS的小组完成了额外的睡眠 (PSQI,ESS),疲劳 (MFIS) 和抑郁 (BDI) 评估.
- 进行了相关性和组分析,以评估关系和表型特异性的差异.
主要成果:
- 与复发性多发性硬化症患者相比,进展性多发性硬化症患者表现出明显更大的身体残疾,较差的认知功能和较低的 QoL.
- 在整个队列中,QoL与身体残疾 (EDSS) 和认知表现 (SDMT) 有很强的相关性,身体测量显示出更强的联系.
- 在复发性MS中,身体和认知障碍都影响了QoL,而身体残疾是进展性MS的主要因素.
- 在睡眠小组中,睡眠质量差 (PSQI),睡眠延迟时间较长和白天嗜睡与疲劳增加,抑郁和 QoL 降低有关.
结论:
- 在MS QoL是一个复杂的结果,受到身体残疾,认知障碍,疲劳,抑郁和睡眠质量的影响,在不同的MS表型中观察到不同的模式.
- 身体残疾是渐进性多发性硬化症中QOL降低的主要驱动因素,而认知缺陷,特别是处理速度减慢,对复发性多发性硬化症中QOL有显著影响.
- 包括睡眠和情绪查在内的全面的多维评估对于制定PwMS个性化管理策略至关重要.
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